Navigation Links
Different anticoagulant regimens yield equal results
Date:12/4/2007

NEW YORK, NY DECEMBER 4, 2007 Patients with acute coronary syndromes (ACS) receiving early invasive treatment including angiography and percutaneous coronary intervention (PCI) have comparable results at 1 year in terms of mortality and ischemic outcomes no matter which of three different anticoagulant regimens they are on, according to a study in the December 5 issue of the Journal of the American Medical Association.

Researchers led by Gregg W. Stone, MD, Chairman of the Cardiovascular Research Foundation in New York and Professor of Medicine and Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy, Columbia University Medical Center, looked at over 13,000 patients with ACS (unstable angina or less severe heart attacks known as non-ST-elevation myocardial infarctions) who were given either heparin plus glycoprotein (GP) IIb/IIIa inhibitors (4,603 patients), the thrombin (blood-clotting enzyme) inhibitor bivalirudin by itself (4,612 patients), or bivalirudin plus GB IIb/IIIa inhibitors (4,604 patients).

Anticoagulant drug regimens are normally given in patients undergoing PCI to reduce the bleeding and ischemic complications that can result from these procedures. In earlier research, the same group of investigators showed that patients with ACS who received an early invasive management strategy who received bivalirudin alone experienced similar rates of ischemic complications but significantly reduced rates of major bleeding at 30 days compared with similar patients receiving bivalirudin plus GP IIb/IIIa inhibitors. As a result, less blood transfusions were required in this group of patients, and hospital costs were reduced. However, the long-term effect of bivalirudin monotherapy on composite ischemia and death are unknown.

In the short term, the optimal pharmacological regimen to support the invasive approach in ACS would ideally suppress adverse ischemic and thrombotic events while minimizing iatrogenic [induced by treatment] bleeding, Dr. Stone said.

Results from the recent study, called the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial, showed that compared with the control group of heparin plus GP IIb/IIIa inhibitors in which the 1-year estimated rate of composite ischemia was 15.4 percent, composite ischemia occurred in 16.0 percent of patients assigned to bivalirudin plus GP IIb/IIIa inhibitors and in 16.2 percent of patients assigned to bivalirudin alone. Death at 1 year occurred in an estimated 3.9 percent of patients assigned to heparin plus GP IIb/IIIa inhibitors, 3.9 percent assigned to bivalirudin plus GP IIb/IIIa inhibitors, and 3.8 percent assigned to bivalirudin monotherapy. Between 30 days and 1 year, a trend was present for fewer deaths in the patients assigned to bivalirudin monotherapy compared to heparin plus IIb/IIIa inhibitors or bivalirudin plus IIb/IIIa inhibitors (96 vs. 114 vs. 105 deaths respectively).

At 1 year, there were no statistically significant differences in the rates of composite ischemia or mortality among patients with moderate- and high-risk ACS undergoing invasive treatment with the three anticoagulant regimens, Dr. Stone said. Thus, bivalirudin alone, which decreases bleeding and transfusions, as well as hospital costs, as well as simplifies and streamlines care compared to heparin plus IIb/IIIa inhibitors, should be favored in most patients with ACS undergoing early invasive treatment.


'/>"/>

Contact: Claire Laporte
claporte@crf.org
212-851-9311
Cardiovascular Research Foundation
Source:Eurekalert

Related medicine news :

1. Brain cells work differently than previously thought
2. Different method of evaluating the urinary tract system reduces radiation dose
3. Different HIV rates among gay men and straight people not fully explained by sexual behavior
4. Abaxis Launches The VetScan(R) HM5 a State-of-the-Art 5-Part Differential Veterinary Hematology Analyzer
5. Sense of taste different in women with anorexia nervosa
6. Babies raised in bilingual homes learn new words differently than infants learning one language
7. Children would need different medical care in wake of dirty bomb
8. Penn researchers use brain imaging to demonstrate how men and women cope differently under stress
9. Multiple Sclerosis Patients Find Dietary Treatment More Effective Than Pharmaceutical Regimens
10. Liver cancer marker could yield blood test for early detection
11. Improving doctor-patient communication yields significant health benefits
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/12/2016)... ... February 12, 2016 , ... Each year, the American Physical ... in Anaheim, CA at the Anaheim Convention Center. Almost 10,000 physical therapists across the ... products in action, learn more about their chosen field and network with their colleagues. ...
(Date:2/12/2016)... Atlanta, GA (PRWEB) , ... February 12, 2016 ... ... and relationship-marketing firm announced that nominations have closed for the ISE Southeast Awards ... categories will be announced at the ISE® Southeast Executive Forum and Awards Gala ...
(Date:2/12/2016)... , ... February 12, 2016 , ... Every winter, someone ... This winter the West Penn Burn Center, part of the Allegheny Health ... to bring you the “Space Heaters Need Space” campaign. , “Space ...
(Date:2/12/2016)... ... ... The Jones Agency, a family owned insurance company with offices serving Arlington, Dallas, ... with the Tarrant Area Food Bank in the hopes of alleviating hunger for nearby ... Tarrant County Food Bank offers hope and security to the one in six Texas ...
(Date:2/12/2016)... ... February 12, 2016 , ... Young Asset Protection, a full ... of the latest charity campaign in their community enrichment program. Art Expression utilizes ... worthy cause are currently being accepted at: http://artexpressioninc.org/ . , Art Expression ...
Breaking Medicine News(10 mins):
(Date:2/11/2016)... -- The primary goal of this research is to ... usage of liquid biopsy. Key information the survey seeks ... of liquid biopsy adoption amidst future users - Predominantly ... - Sample inflow to conduct liquid biopsy tests - ... so on. - Correlation analysis of sample type and ...
(Date:2/11/2016)... SAN FRANCISCO , Feb. 11, 2016  Kindred ... focused on saving and improving the lives of pets, ... Technical Section of the New Animal Drug Application (NADA) ... the pivotal field study (KB0120) of Zimeta for the ... by the Company. --> ...
(Date:2/11/2016)... Feb. 11, 2016 Potrero Medical, Inc., the developer ... announce the appointment of George M. Rapier, III , ... Antonio, TX , WellMed is one of the nation,s ... and HMO members in Texas and ... out of his own internal medicine practice, he has been ...
Breaking Medicine Technology: